nelfinavir, Viracept (cont.)

Omudhome Ogbru, PharmD

Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

DRUG INTERACTIONS:
Nelfinavir interacts with many drugs because it reduces the ability of liver enzymes to break down certain drugs. Some of the important interactions are discussed below. Viewers should consult their health care professional before combining any drugs with nelfinavir.

Nelfinavir should not be used together with alfuzosin (Uroxatral), lovastatin (Mevacor), simvastatin (Zocor), pimozide (Orap), sildenafil (Revatio), amiodarone (Cordarone), quinidine (Quinaglute, Cardioquin), ergot derivatives (for example, Ergostat), triazolam (Halcion), and midazolam (Versed), because serious adverse effects could occur due to increased levels of these drug in the body.

Nelfinavir also may increase blood levels of vardenafil (Levitra, Staxyn), tadalafil (Cialis, Adcirca), and sildenafil (Viagra), leading to increased side effects. Dosage adjustments are recommended.

Nelfinavir also increases the concentrations in blood of rifabutin (Mycobutin). Therefore, the doses of rifabutin should be reduced.

Rifampin and St. John's wort decrease the concentration of nelfinavir in the body and may reduce the effectiveness of nelfinavir.

Nelfinavir may decrease the effectiveness of oral contraceptives.

PREGNANCY: Nelfinavir has not been adequately evaluated in
pregnant women.

NURSING MOTHERS: It is not known whether nelfinavir is secreted in
breast milk. Nevertheless, HIV-infected mothers should not breastfeed because of the potential risk of transmitting HIV to an infant that is not infected.